消化系统肿瘤的分子靶向治疗

Clinical effects of bevacizumab combined with chemotherapy for advanced colorectal cancer

AIM: To evaluate the clinical effects of bevacizumab combined with chemotherapy in the treatment of advanced colorectal cancer.

METHODS: One hundred and seventy-eight patients with advanced colorectal cancer were divided into either an observation group (85 cases) or a control group (93 cases). The observation group was treated by bevacizumab combined with chemotherapy, and the control group was treated by XELOX chemotherapy. The clinical effects, side effects, and quality of life were compared for the two groups.

RESULTS: The response rate for the observation group was significantly better than that for the control group (67.06% vs 47.31%, P < 0.05). The rate of bone marrow suppression for the observation group was significantly lower than that for the control group (26.32% vs 50.54%, P < 0.05). There were no significant differences in the rates of bone marrow suppression, neurotoxicity, gastrointestinal reaction, liver and kidney toxicity, or immune system disorders (25.88% vs 26.88%, 17.65% vs 20.43%, 20.00% vs 23.66%, 15.29% vs 11.83%, 11.76% vs 8.60%, P > 0.05). The scores of quality of life for the observation group posttreatment were similar to prior-treatment values (65.62 ± 3.34 vs 67.83 ± 4.06, 67.67 ± 3.46 vs 69.26 ± 3.98, 66.15 ± 3.52 vs 68.11 ± 3.96, 66.58 ± 3.51 vs 68.02 ± 4.02, 66.83 ± 3.55 vs 68.39 ± 3.81, P > 0.05). The scores of quality of life for the control group were significantly lower after treatment than prior-treatment (51.57 ± 3.26 vs 67.89 ± 4.11, 54.62 ± 3.31 vs 69.30 ± 3.89, 53.24 ± 3.28 vs 68.15 ± 3.92, 52.26 ± 3.22 vs 67.97 ± 4.11, 53.16 ± 3.28 vs 68.41 ± 3.80, P < 0.05).

CONCLUSION: Bevacizumab combined with chemotherapy has better clinical effects than chemotherapy alone in the treatment of advanced colorectal cancer, without significant impact on side effects and quality of life.

EGFR-targeted drugs for colorectal cancer: current status and future challenges

Colorectal cancer is a common gastrointestinal malignancy. The effects of traditional chemotherapy and radiation therapy against colorectal cancer are not satisfactory. The epidermal growth factor receptor (EGFR) signaling pathway plays an important role in tumor proliferation, angiogenesis, invasion, and metastasis in colorectal cancer. EGFR-targeted drugs have been developed and applied to the treatment of colorectal cancer. This paper provides a literature review on the current status and future challenges of EGFR-targeted therapy of colorectal cancer.

Expression of EGFR, HER-2, VEGF in tumour tissues and their directive significance for the molecular targeting therapy of colorectal carcinoma

AIM: To detect the characteristics of epidermal growth factor receptor (EGFR), human epidermal receptor-2 (HER-2) and vascular endothelial growth factor (VEGF) expression in colorectal carcinoma (CRC) tumor tissues, and to analyze their directive significance for the molecular targeting therapy of colorectal carcinoma (CRC).

METHODS: Seventy eight patients with CRC were randomly selected, who underwent radical surgery in the department of general surgery at our hospital from May 2005 to March 2009. The SP Immunohistochemical staining was used to detect EGFR, HER-2 and VEGF protein expression in 78 CRC tumor tissue samples. And their corresponding clinical data were analysed retrospectively.

RESULTS: The expression rates of EGFR, HER-2 and VEGF protein in CRC tumour tissue were 38.5% (30/78), 53.8% (42/78) and 41.0% (32/78). Positive rates of EGFR, HER-2 and VEGF protein were closely relevant to the tumour size, knubbly invasive depth and lymph node metastasis; but not to the patient's sex, age, tumor site or histology grade. There was a stable positive relationship among EGFR, HER-2 and VEGF expression in CRC tumour tissue samples. The related coefficients were 0.421, 0.484 and 0.469 respectively (P = 0.019, 0.012 and 0.016).

CONCLUSION: The present study demonstrates that the EGFR, HER-2 and VEGF expression participate in the development, invasion and metastasis process of CRC. Their joint detection can be looked as an important symbol for judging the prognosis of CRC, screening the high-risk metastasis patients and guiding the molecular targeting therapy of colorectal carcinoma.